PERIRADICULAR CURETTAGE

Periradicular curettage is a part of the treatment procedure of perira dicular surgery, Its main purpose is to remove pathological periradicu lar tissues for visibility and accessibility to facilitate the treatme nt of the apical root canal system, or sometimes for the removal of ha rmful foreign materials present in the periradicular area. Inflammator y periradicular lesions (granuloma and cysts) are the responses of the periradicular tissues to irritants from the root canal and not from t he periradicular area unless medicaments and/or filling materials have been forced through the apical foramina or perforations into the peri odontium. Histologically, the inflammatory periradicular lesion is sim ilar to healing granulation tissue, which is composed of cells which h ave natural and specific immunological defence capability and cooperat e by means of cytokines to amplify the protective mechanisms of the ho st, Accordingly, it is not necessary to completely curette out all the inflamed periradicular tissues during surgery, since this granulation -like tissue will be incorporated into the new granulation tissue as p art of the healing process. To control the source of irritants in the root canal is far more important than to remove all periradicular tiss ues affected by the irritants, The successful removal of all irritants from the root canal system results in resolution of pulpally induced periradicular lesions, In the case where the periradicular lesion is c aused by endodontic instruments or cytotoxic filling materials placed in the periradicular tissues, removal of these foreign objects is requ ired for resolution of the lesion.